AB1341 ASSESSMENT OF COMMON FEMORAL VEIN INTIMA-MEDIA THICKNESS BY ULTRASOUND IN BEHÇET’S DISEASE: COMPARATIVE STUDY OF PATIENTS WITH OR WITHOUT VASCULAR INVOLVEMENT IN A NATIONAL REFERRAL CENTER
Authors: D. Prieto-Peña, A. Del Peral Fanjul, B. Atienza-Mateo, V. Pulito-Cueto, M. A. González-Gay, R. Blanco
Journal: Annals of the Rheumatic Diseases (2022)

Background Vascular manifestations are frequent in Behçet’s disease (BD). However, they have been less studied than other manifestations, such as uveitis [1]. Increased venous wall thickness assessed with ultrasound (US) has been reported in BD [2]. However, it remains unclear if US findings correlate with vascular involvement in BD. Objectives To assess vascular Doppler US findings in patients with BD with and without clinical vascular manifestations. Methods Observational study of unselected consecutive patients with BD assessed in a national referral center, from March 2021 to May 2021. All patients fulfilled the 2014 ICBD criteria [3]. They were evaluated sequentially with a scheduled clinic visit after signing an informed consent. Demographic and clinical variables were collected. Patients were considered to have vascular involvement if they had history of deep vein thrombosis, pulmonary thromboembolism, superficial thrombophlebitis, arterial thrombosis (peripheral arterial thrombosis, stroke, transient ischemic attack), aneurysms, acute myocardial infarction or Raynaud’s disease. Wall thickness of bilateral common femoral vein was measured by assessing the intima-media thickness (IMT) with a high-resolution Doppler US [2]. Statistical analysis was performed with SPSS. Student´s t test or Mann-Whitney U test was used to compare continuous variables, and Chi-squared test or Fisher´s exact test for categorical variables, as appropriate. Results We evaluated 17 BD patients with vascular manifestations and 25 BD patients without vascular manifestations. Main clinical and demographic characteristic are described in Table 1. The vascular manifestations were deep vein thrombosis (n=4), superficial thrombophlebitis (n=1), arterial aneurysms (n=2), acute myocardial infarction (n=3), arterial thrombosis (n=1) and Raynaud’s disease (n=10). The median [IQR] value of the common femoral vein IMT was significantly higher in patients with vascular manifestations (0.65 [0.45-0.82] vs 0.49 [0.39-0.55]; p= 0.028). A significant increase in vascular manifestations was observed in patients with arterial hypertension (p=0.003). HLA B51 presence was more frequent in patients with no vascular manifestations. Table 1. Vascular manifestations (n=17 ) Without vascular manifestations (n=25 ) P value Sex (men ), n (%) 10 (41.2) 13 (48) 0.663 Age (years), mean ± SD 51.24±12.8 45.56±12.88 0.133 HLA B51 positive, n/tested cases 4/17 14/25 - Evolution time (years) from diagnosis, mean ± SD 13.35 ± 10.45 13.04 ± 8.52 0.891 Cardiovascular risk factors Hypertension, n (%) 7 (41.2) 1 (4) 0.003 Diabetes mellitus, n (%) 1 (5.9) 2 (8) 0.794 Dyslipidemia, n (%) 6 (35.3) 5 (20) 0.268 Smoking habit (current or former smokers ), n (%) 10 (58.8) 12 (48) 0.067 Clinical manifestations Oral ulcers, n (%) 16 (94.1) 25 (100) 0.220 Genital ulcers, n (%) 12 (70.6) 16 (64) 0.657 Erythema nodosum like, n (%) 9 (52.9) 6 (24) 0.055 Pseudofolliculitis, n (%) 9 (52.9) 19 (76) 0.120 Uveitis, n (%) 7 (41.2) 9 (36) 0.735 Arthralgia, n (%) 14 (82.4) 17 (68) 0.299 Neurological manifestations, n (%) 2 (11.8) 2 (8) 0.683 Ultrasound findings Femoral vein IMT (mm), median [IQR] 0.65 [0.45-0.82] 0.49 [0.39-0.55] 0.028 IMT: intima-media thickness. IQR: interquartile range. Conclusion Patients with BD and vascular involvement present higher values of common femoral vein IMT. The assessment of venous wall thickness with Doppler US constitutes a useful technique to evaluate clinical vascular involvement in BD patients. References [1]Atienza-Mateo B, et al. Arthritis Rheumatol. 2019 Dec;71(12):2081-2089. doi: 10.1002/art.41026. [2]Alibaz-Oner F, Ergelen R, Yildiz Y, Aldag M, Yazici A, Cefle A, et al. Femoral vein wall thickness measurement: A new diagnostic tool for Behçet’s disease. Rheumatology (Oxford). 2021 01 5;60(1):288-96. [3]International Team for the Revision of the International Criteria for Behçet’s Disease (ITR-ICBD). J Eur Acad Dermatol Venereol. 2014 Mar;28(3):338-47. Disclosure of Interests None declared